Social Capital Role in Managing High Risk Behavior: a Narrative Review

Factors associated with improvements in symptoms of anxiety and depression among gay, bisexual and other men who have sex with men (gbMSM) in Vancouver, Canada: A prospective cohort study

BACKGROUND

Depression and anxiety are commonly experienced among gay, bisexual and other men-who-have-sex-with-men (gbMSM). We explored factors associated with improvements in mental health symptoms among gbMSM with abnormal depression and anxiety scores over a period of four years, in Vancouver, Canada.

METHODS

Sexually active gbMSM ≥16 years of age were recruited using respondent-driven sampling from February 2012 to February 2015. Participants completed a computer-assisted questionnaire which included the Hospital Anxiety and Depression Scale (HADS), and psychometric scales to measure loneliness, self-esteem and social connectedness, every 6 months until July 2019. Generalized linear mixed models were used to assess factors associated with normal/borderline HADS scores (<11) following a previous abnormal score (≥11) for each of anxiety and depression subscales.

RESULTS

We recruited 694 participants, of whom 580 had at least one follow-up visit. Across all visits, 43.6 % of participants ever had abnormal anxiety scores and 16.2 % ever had abnormal depression scores. Among those with abnormal anxiety scores, 34.9 % of follow-up visits demonstrated reductions in anxiety scores. Among those with abnormal depression scores 51.0 % of follow-up visits demonstrated reductions in depression scores. Reductions in anxiety scores were associated with increased self-esteem, decreased loneliness and the number of gbMSM seen/spoken to in the previous month. Reductions in depression scores were associated with increased self-esteem, decreased loneliness and having a regular partner.

CONCLUSION

Improvements in mental health symptoms were frequently observed. Social connectedness was related with improved anxiety and depression symptoms. Interventions to improve social connectedness may help to improve mental health for gbMSM.

Psychometric properties of a Persian version of the Vulvovaginal Symptoms Questionnaire for measuring vulvovaginal symptoms in postmenopausal women

OBJECTIVE

Vulvovaginal symptoms are common in postmenopausal women and can affect their quality of life and sexual function. Using a sample of postmenopausal Iranian women, we evaluated a Persian translation of the Vulvovaginal Symptoms Questionnaire (VSQ).

METHODS

This study included 201 postmenopausal Iranian women referred to dermatology and gynecology clinics affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. We translated the VSQ to the Persian language using the forward-backward method. We examined the questionnaire's internal consistency using Cronbach α coefficient and evaluated its construct validity using exploratory and confirmatory factor analyses.

RESULTS

A Cronbach α coefficient of 0.763 confirmed the overall internal consistency of the Persian VSQ. Exploratory factor analysis indicated that except for three items in the symptoms subscale, others had sufficient α coefficients, although some did not load on the expected subscales. Confirmatory factor analysis confirmed the appropriate allocation of all but two items to the expected subscales. An intraclass correlation coefficient of 0.89 confirmed the reliability of the questionnaire.

CONCLUSIONS

Although some parts of the Persian VSQ were unsatisfactory, most were appropriate for assessing vulvovaginal symptoms in postmenopausal Iranian women. We recommend further cultural adaptations.

Comparison of reproductive health and its related factors in vulnerable and nonvulnerable women

BACKGROUND

Women's health is supposed to be one of the indicators of development. Reproductive health is an important part of women's health. Vulnerable women are a group of women whose reproductive health needs to be given special attention. The purpose of this study was to compare the reproductive health of vulnerable and nonvulnerable women.

MATERIALS AND METHODS

This cross-sectional study was conducted on vulnerable women (n = 250) and nonvulnerable women (n = 250). The samples were selected from vulnerable women's centers and comprehensive health centers in Isfahan by quota and using simple random sampling method in 2017. The research tool was a researcher-made questionnaire completed by the researcher using interview method. Internal reliability of the questionnaire was confirmed to be 0.89 using Cronbach's alpha. A P < 0.05 was considered to be statistically significant. Data analysis was performed using SPSS 18 software and independent t-test, Mann-Whitney, Pearson, Spearman, and Chi-square tests.

RESULTS

The results showed that the mean total score of reproductive health in the nonvulnerable group (81.41) was significantly higher than that of the vulnerable group (68.6). The mean total score and the score of reproductive health components, except some of them, were significantly different between the two groups (P < 0.05). Having an addicted spouse and unsafe sex were the most prevalent features associated with high-risk behaviors.

CONCLUSIONS

According to the results, reproductive health status of vulnerable women is inappropriate in all dimensions. Given the importance of this issue, the development and implementation of special health programs for this group seem to be necessary.

Does Social Capital Promote Health?

The determinants of health are influenced by genetics, lifestyle, social environment, medical conditions, etc. As an informal system, social capital plays an increasingly recognized role in individual health. The purpose of this paper is to discuss the direct and indirect effects of social capital on individual health in China. Using cross-sectional data from the China Family Panel Studies 2016, this paper explores the effects of cognitive and structural social capital on individual health from a micro perspective. The results show that both types of social capital have significant positive effects on individual health, and this effect remains after endogeneity is considered. The two types of social capital show obvious heterogeneity in age samples, urban and rural samples and north-south samples. In addition, the mechanism analysis shows that the health promotion effects of the two types of social capital are mainly derived from the effects of informal finance and access to medical resources. Based on the above findings, this paper puts forward policy recommendations.

A psychometric assessment of a network social capital scale among sexual minority men and gender minority individuals

BACKGROUND

Social capital, the potential for individuals to access resources through group memberships, is linked to a constellation of health outcomes. We modified a previously evaluated Constructed Family Social Capital Scale for gay, bisexual and other men who have sex with men who belong to constructed families to create a new measure of social capital within sexual minority men and gender minority individuals' social networks.

METHODS

Participants were recruited from a Pride festival in Milwaukee, Wisconsin in 2018 to complete a cross-sectional survey. This analysis is restricted to 383 participants who identified as sexual minority men or gender minority individuals and completed nine items measuring social capital within their social networks. We conducted exploratory and confirmatory factor analyses to assess factor structure. Internal consistency was measured using Cronbach's alpha.

RESULTS

Reliability was high, indicating the scale's utility to assess Network Social Capital among sexual minority men and gender minority individuals. A single-factor solution with high factor loadings was found for the nine-item scale.

CONCLUSIONS

This study extended the psychometric properties of a preliminary social capital instrument modified from a prior study in a different population and context. The modified measure has implications for use among sexual minority men and gender minority individuals to measure social capital within social networks. Previous studies suggest that interventions to enhance social capital among sexual minority men and gender minority individuals may be beneficial for HIV prevention interventions. This tool may be relevant for the evaluation of social capital interventions within networks of sexual minority men and gender minority individuals.

A pathway analysis of exploring how HIV-related stigma affects social capital among people living with HIV/AIDS in China

HIV-related stigma is the most common and serious social problem which people living with HIV/AIDS (PLWHA) have to face. However, the impact of HIV stigma on social capital is not yet clear. Therefore, this study aims to understand the relationship between HIV stigma and social capital, and explore the mechanism of how HIV stigma influences social capital among Chinese PLWHA on this basis. An institutional based cross-sectional study was conducted from Nov 2015 to Jan 2016 in Wuhan, China, using a self-reporting questionnaire. A total of 552 PLWHA participated, and 520 valid questionnaires were included. Multiple linear regression analysis showed that lower education level, lower monthly income, higher internalized stigma, and anticipated stigma were significantly associated with lower social capital. Results of path analysis showed that although perceived community stigma has no direct effect on social capital, but it can affect social capital through internalized stigma and anticipated stigma. In conclusion, increased HIV stigma and reduced social capital are frequent among PLWHA in China. Perceived community stigma may cause PLWHA to internalize stigma and anticipate stigmatizing experiences, resulting in the reduction of social capital. These findings suggest that perceived community stigma should become the target of stigma intervention strategy among Chinese PLWHA.

Voices from Australia- concerns about HIV associated neurocognitive disorder

This study aimed to determine whether people living with HIV (PLHIV) are concerned about HIV associated neurocognitive disorder (HAND) and would find information and resources for HAND beneficial. An online survey focusing on the experience of HAND was distributed via the website of Positive Life New South Wales: a peak peer-support non-government organization in Australia. Of 126 respondents, 94 (74%) had heard of HAND, 52/94 (55%) had experienced concerns and of these, 48/52 (92%) felt anxiety about discussing the subject. Of those who had experienced concerns, 30/52 (58%) had spoken to someone about these concerns and 23/30 (77%) had received a positive response. Across the entire sample, 74 (59%) had noticed symptoms of cognitive decline in themselves and/or others. Respondents who noted a decrease in their ability to organize were on average five years older than those who had not noticed a decline (p = 0.012, effect size -.54). Forty-nine (39%) indicated that they would like guidance to initiate discussion about HAND with their doctor, caregiver or other PLHIV. The survey findings suggest that increasing awareness of HAND among PLHIV and their caregivers, and providing resources to facilitate discussion about HAND may assist to reduce concerns among PLHIV and enhance the effectiveness of clinical review.

Number of Psychosocial Strengths Predicts Reduced HIV Sexual Risk Behaviors Above and Beyond Syndemic Problems Among Gay and Bisexual Men

Syndemics research shows the additive effect of psychosocial problems on high-risk sexual behavior among gay and bisexual men (GBM). Psychosocial strengths may predict less engagement in high-risk sexual behavior. In a study of 470 ethnically diverse HIV-negative GBM, regression models were computed using number of syndemic psychosocial problems, number of psychosocial strengths, and serodiscordant condomless anal sex (CAS). The number of syndemic psychosocial problems correlated with serodiscordant CAS (RR = 1.51, 95% CI 1.18-1.92; p = 0.001). When adding the number of psychosocial strengths to the model, the effect of syndemic psychosocial problems became non-significant, but the number of strengths-based factors remained significant (RR = 0.67, 95% CI 0.53-0.86; p = 0.002). Psychosocial strengths may operate additively in the same way as syndemic psychosocial problems, but in the opposite direction. Consistent with theories of resilience, psychosocial strengths may be an important set of variables predicting sexual risk behavior that is largely missing from the current HIV behavioral literature.

Engagement of Gay Men and Other Men Who Have Sex with Men (MSM) in the Response to HIV: A Critical Step in Achieving an AIDS-Free Generation

Men who have sex with men (MSM) continue to be at elevated risk for HIV acquisition and transmission secondary to biological and behavioral characteristics, social and sexual network characteristics, community environmental factors, and structural factors. HIV incidence rates remain high among MSM in both low- and high-income settings, and in both concentrated and more generalized HIV epidemic settings. While data quality tends to be poorer, the best estimates collectively suggest that MSM have up to 20 times the odds of living with HIV as compared to other reproductive aged adults across low- and middle-income countries. Recent prevention strategies to lower biological HIV transmission and acquisition risks, including the early use of antiretrovirals to decrease infectiousness for those living with HIV, and pre-exposure prophylaxis for those at significant risk of HIV acquisition, have demonstrated the potential to change the trajectory of the HIV epidemics among MSM. However, the coverage and effectiveness of these approaches is limited by structural factors including the punitive legal frameworks and institutional discrimination that contribute to limited uptake, challenges to adherence, and suboptimal health-seeking behaviors among MSM. More intensive efforts will be required to reach MSM who do not currently have access to relevant and effective prevention and treatment services or elect not to access these services given enacted and/or perceived stigma. Respect for human rights, including efforts to aggressively confront and combat the forms of stigma that are preventing us from achieving an AIDS-Free generation, are needed for all people including gay men and other MSM.

Caring for the Unseen: Using Linking Social Capital to Improve Healthcare Access to Irregular Migrants in Spain

PURPOSE

To describe a novel strategy using linking social capital to provide healthcare access to irregular migrants with low literacy, low numeracy, and limited cultural assimilation in a European metropolitan area.

ORGANIZING CONSTRUCT

Public data show numerous shortcomings in meeting the healthcare needs of refugees and irregular migrants surging into Europe. Many irregular migrants living in European communities are unable to access information, care, or services due to lack of social capital. An overview of the problem and traditional charity strategies, including their barriers, are briefly described. A novel strategy using linking social capital to improve healthcare access of irregular migrants is explored and described. Information regarding the impact of this approach on the target population is provided. The discussion of nursing's role in employing linking social capital to care for the vulnerable is presented.

CONCLUSIONS

Immigration and refugee data show that issues related to migration will continue. The novel strategy presented can be implemented by nurses with limited financial and physical resources in small community settings frequented by irregular migrants to improve health care.

CLINICAL RELEVANCE

The health and well-being of irregular migrants has an impact on community health. Nurses must be aware of and consider implementing novel strategies to ensure that all community members' healthcare needs, which are a basic human right, are addressed.